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Tuesday, January 09, 2007

What is Internet misuse and what is addiction?

After my last blog entry, I received several emails from therapists, many whom are EAPs who have seen cases like IBM in their practice. They would treat an employee who did something wrong using the computer and was fired, or on the brink of being fired.

They asked me how they could diagnose Internet addiction and differentiate that from general misuse of the computer. This is a very relevant question to ask in our technology-rich society. The symptoms are based upon DSM criteria as follows:

1. Do you feel preoccupied with the Internet (think about previous online activity or anticipate next online session)?
2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
5. Do you stay online longer than originally intended?
6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?
7. Have you lied to family members, therapist, or others to conceal the extent of involvement with the Internet?
8. Do you use the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?

Answers should evaluate non-essential computer/Internet usage (i.e., non-business or academically related use). Clients are considered addicted when answering “yes” to five (or more) of the questions over a six-month period, when not better accounted for by a manic episode. Associated features among addicted individuals include: (1) ordinarily excessive Internet use, (2) a neglect of routine duties, (3) social isolation from family members and friends, (4) being secretive about online activities or a sudden demand for privacy when online, and (5) significant changes in normal sleep patterns (depravation). While many people may spend too much time online that in itself is not the only criteria to diagnose addiction. Therapists must also evaluate how the Internet is impacting a client’s life and look beyond diagnosis as purely a function of time.